Eighth Hospital of Shanxi Medical University, Yuncheng Central Hospital, No.3690 Hedong East Street, Yanhu District, Yuncheng City, Shanxi Province, China.
Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, No. 99 Longcheng Street, Taiyuan City, Shanxi Province, China.
Radiol Med. 2024 Mar;129(3):368-379. doi: 10.1007/s11547-024-01793-z. Epub 2024 Feb 14.
To investigate the correlation between changes in the thickness and density of diseased small-bowel wall and small-bowel ischemia and necrosis (SBN) on CT imaging when small-bowel obstruction (SBO) occurs.
We retrospectively analyzed 186 patients with SBO in our hospital from March 2020 to June 2023. The patients were divided into simple SBO (control group) and SBN (case group) groups. We used logistic regression analysis, the chi-square test, and Fisher's exact test to analyze the correlation between the changes in the thickness and density of the diseased intestinal wall and the SBN. A receiver operating characteristic (ROC) curve was used to calculate the accuracy of the multivariate analysis.
Of the 186 patients with SBO, 98 (52.7%) had simple SBO, 88 (47.3%) had SBN, and the rate of SBN was 47.3% (88/186). Multivariate regression analysis revealed that six CT findings were significantly correlated with SBN (p < 0.05), namely, thickening of the diseased intestinal wall with the target sign (OR = 21.615), thinning of the diseased intestinal wall (OR = 48.106), increase in the diseased intestinal wall density (OR = 13.696), mesenteric effusion (OR = 21.635), decrease in the diseased intestinal wall enhancement on enhanced scanning (OR = 41.662), and increase in the diseased intestinal wall enhancement on enhanced scanning (OR = 15.488). The AUC of the multivariate analysis reached 0.987 (95% CI 0.974-0.999). Specifically, the target sign was easily recognizable on CT images and was a significant CT finding for predicting SBN.
We identified 6 CT findings that were significantly associated with SBN, and may be helpful for clinical treatment.
探讨小肠梗阻（SBO）时病变小肠壁厚度和密度的变化与小肠缺血坏死（SBN）的相关性。
回顾性分析 2020 年 3 月至 2023 年 6 月我院收治的 186 例 SBO 患者，将患者分为单纯 SBO（对照组）和 SBN（病例组）。采用逻辑回归分析、卡方检验和 Fisher 确切概率法分析病变肠壁厚度和密度变化与 SBN 的相关性。采用受试者工作特征（ROC）曲线计算多因素分析的准确性。
186 例 SBO 患者中，单纯 SBO 98 例（52.7%），SBN 88 例（47.3%），SBN 发生率为 47.3%（88/186）。多因素回归分析显示，有 6 项 CT 表现与 SBN 显著相关（p<0.05），即靶征样病变肠壁增厚（OR=21.615）、病变肠壁变薄（OR=48.106）、病变肠壁密度增高（OR=13.696）、肠系膜积液（OR=21.635）、增强扫描病变肠壁强化程度降低（OR=41.662）和增强扫描病变肠壁强化程度增高（OR=15.488）。多因素分析的 AUC 为 0.987（95%CI 0.974-0.999）。具体而言，靶征在 CT 图像上容易识别，是预测 SBN 的重要 CT 表现。
本研究发现了 6 项与 SBN 显著相关的 CT 表现，可能有助于临床治疗。
